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Ultrasound and puppy with "sounds" on every fourth

I know of someone who's Vet has recommended an UltraSound for a puppy, age 9 weeks, with a "sound" on every fourth heartbeat. Could this be a normal "puppy flow murmur" or something else, maybe a Vet trying to be cautious or make some money?

Others more informed will hopefully come in on this, but I'd guess he's talking about a murmur that is likely to be a flow murmur. If there's a concern about a heartbeat I don't think I'd consider it a waste of money ever to get a baseline scan so that they have more detail on what is going on, and can compare it to scans as the puppy gets older. While flow murmurs are not uncommon and do tend to dsiappear, I don't think they should be taken casually and they should be closely watched. I'd have your friend get a second opinion if she doubts the vet's intentions.

Hi Deb,
I'm no vet. or anything, but I do have a puppy with a heart murmur. We got him at 10 weeks and he had the murmur then. It was the first vet visit we had taken him to and our vet definitely heard the murmur, she suggested we contact the breeder and discuss what to do.
The breeder had us take our puppy, Riley, to a cardiologist. The cardiologist did listen to his heart and confirmed the murmur, but did not do any diagnostic tests. I really wish we could have had the tests as Riley at his last vet visit (14 weeks old) still has a murmur. If there was any way that I could have had any tests that would have given us more information about his heart, I would have them done. But I was told by 2 cardiologists that in a puppy that young, the tests would be inconclusive and they would be unable to determine anything more until Riley was at least 16 weeks old. I still don't feel comfortable with that answer, but Riley is almost 16 weeks now, so we will be seeing the vet. at the end of the week. Hopefully his murmur will be better.
It it were me, I would have whatever tests I could to determine the health of my puppy's heart. There are just so many things that could affect their heart health, I think it's worth it to know right now what you could be facing in the future. Flow murmur are not uncommon and usually go away as the puppy gets older. However, it may not be a flow murmur, so why not find out what is going on, if you can. Anyway, that's how I see it, maybe it helps you a bit.
Laura

Laura thanks for that more informed post. Deb, based on what Laura is saying, I think I'd ask for a referral to a cardiologistfirst, and see what the cardiologist says, rather than getting an ultrasound though the vet, if that was to be done without a cardiologist seeing the pup.

Ok, latest from the puppy owner, ultrasound and ekg show a problem with left ventrical but nothing to worry about?, not MVD. The results are being forwarded to a cardiologist for interpretation and results. Has anyone had a Cav with this type of problem?

This sounds like a puppy flow murmur. It couldn't be MVD at that age -- MVD is a condition that occurs as a dog ages and its heart valves begin to wear out. Usually it is a condition of old age in dogs (or humans) but cavaliers unfortunately have inherited a genetic predisposition to have the valves give out early in many cases. But still, 'early' usually takes at least two years of the heart pumping away for the valve to start to fail or become more flimsy. It isn't a condition where it would be present at birth. There could be other heart problems that might be present at birth. There are a couple of earlier threads on this issue. Sounds like the vet was saying this is a flow murmur involving the left ventricle and nothing to worry about. FYI this is from the UK cavalier club website:

FLOW MURMURS - WHAT THEY MEAN

Simon Swift
May 2004

A heart murmur is caused by vibrations in the heart. or blood vessels. These vibrations are usually created by turbulence, and occasionally by vibrations of structures in the heart e.g, valves, Just imagine a. river flowing slowly and smoothly, that is laminar flow, Now picture a small fast-flowing stream with lots of currents and eddies, this is turbulent flow.

Turbulence is due to one of three things:

High velocity blood flow
Low blood viscosity - as seen in anaemia
Flow from a narrow region into a large area

Each heart beat ejects a certain volume of blood, the stroke volume, Puppies have larger stroke volumes for their size than adult dogs. This means that for each heart beat, a relatively larger volume of blood is ejected out a smaller vessel when compared to an adult dog. When excited such as at a veterinary surgery, this can increase further and so the outflow velocity from the ventricles in the aorta or pulmonary artery can increase above a certain threshold and become turbulent creating a murmur.

Typically these innocent flow murmurs tend to be fairly quiet (up to grade 3), soft and blowing in character and occur at the beginning to middle of the heart heat, Also they are usually loudest over the aorta or pulmonary artery and can vary with body position. Unfortunately, it is impossible to differentiate between some mild congenital heart diseases such as sub-aortic stenosis (a narrowing under the valves at the base of the aorta) and a flow murmur. Most importantly, innocent flow murmurs disappear by 6 months of age.

If you have a puppy with a murmur that could be a flow murmur, you have two options:

Have the puppy re-examined in 1 month. An innocent flow murmur should get quieter as the puppy grows. If the murmur is the same or louder, further investigations such as Doppler ultrasound examination would be indicated.

Have a Doppler ultrasound examination performed if you need to know NOW. This will allow the cardiologist to assess the valves and the speed and direction of blood flow through the heart can be measured. This will differentiate between mild heart disease and flow murmurs.
Hence, if I pick up a quiet murmur in a young puppy at a show, I would recommend that the owner waits to see how it develops before making any drastic decisions. If it is an innocent flow murmur, it should gradually get quieter and disappear. Anything more significant will persist and require further investigation.